COASTAL DENTAL CARE (NPI# 1063616134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063616134 |
| Entity Type | Organization |
| Organization Name | COASTAL DENTAL CARE |
| Practice Address |
368 Charlie Smith Sr Hwy Saint Marys GA 31558-3101 |
| Practice Telephone | 9128829602 |
| Practice Fax Number | 9128827564 |
| Mailing Telephone | 9128829602 |
| Mailing Fax Number | 9128827564 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JEFFREY N PENNINGTON (DOCTOR) |
| Authorized Official Telephone | 9128829602 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | UNITED CONCORDIA | 1646968 | 01 |
| Street Address |
368 CHARLIE SMITH SR HWY |
| City | SAINT MARYS |
| State | GA |
| Zip Code | 31558-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972652444 | Edward Sidney Parker Jr. | Dentist | 368 Charlie Smith Sr Hwy, Saint Marys, GA 31558-3101 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1922659192 | Christian Bianca Booker | Social Worker | 944 Kings Bay Rd. #247, St. Marys, GA 31558 | 2019-09-27 |
| 1154897296 | Shonta Harper | Counselor | 708 Osborne St Ste 104, Saint Marys, GA 31558 | 2018-10-16 |
| 1174038095 | Camden Behavioral Wellness, Inc | Counselor | 605 Osborne Street, Saint Mary's, GA 31558 | 2017-12-14 |
| 1285149427 | Urgent Care of Coastal Georgia | General Practice | 214 A Professional Circle, St. Marys, GA 31558 | 2017-12-11 |
| 1679975783 | Jeremy Cole | Behavioral Analyst | 921 Charlie Smith Sr. Highway, St. Marys, GA 31558 | 2014-09-19 |
| 1053660738 | Janice Paulino Ramirez | Nurse Practitioner | 2040 Dan Proctor Drive, Suite 170, St Marys, GA 31558 | 2012-09-10 |
| 1174899454 | Light Horse Healthcare Inc | Voluntary or Charitable | 2060 Dan Proctor Drive, Suite 3300, St Marys, GA 31558 | 2012-03-30 |
| 1316215775 | Annette O. Perry | Counselor | 4019 Hwy 40 East, St. Marys, GA 31558 | 2011-12-13 |
| 1932486271 | Sarah Jo Meyers | Speech-Language Pathologist | 2015 Osborne Rd, Unit A, St Marys, GA 31558 | 2011-11-15 |
| Find all providers in zip 31558 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609226448 | Philip Andrew Jenkins | Dentist | 118 Hawthorn Ln Ste A, Saint Marys, GA 31558-9203 | 2016-06-13 |
| 1942559224 | Antoinette Cancelada | Dentist | 104 S Desmet Ln Ste 6, Saint Marys, KS 66536-9826 | 2012-09-03 |
| 1962782680 | J.warren Hildreth, Jr., Dds Pa | Dentist | 310 W Bertrand Ave, Saint Marys, KS 66536-1615 | 2011-08-25 |
| 1124159827 | Joseph J. Hawkins, Dmd PC | Dentist | 1141 S Michael St, Saint Marys, PA 15857-3040 | 2007-03-07 |
| 1881743334 | Dane B Widner | Dentist | 142 W Spring St, Saint Marys, OH 45885-2312 | 2007-01-10 |
| 1972652444 | Edward Sidney Parker Jr. | Dentist | 368 Charlie Smith Sr Hwy, Saint Marys, GA 31558-3101 | 2007-01-10 |
| 1124190731 | Charles Richard Haskell Sr. | Dentist | 106 Wehler Road, Saint Marys, PA 15857 | 2006-11-15 |
| 1255401204 | Richard L Spencer | Dentist | 2101 Osborne Rd, Saint Marys, GA 31558-9137 | 2006-11-08 |
| 1801994876 | Jeffrey Dean Fleagle | Dentist | 124 N Front St, Saint Marys, OH 45885-2392 | 2006-09-21 |
| 1174628168 | Stanley M Prince | Dentist | 124a Andrews Way, Saint Marys, GA 31558-9109 | 2006-09-14 |
| Find all providers in SAINT MARYS | ||||
| City | SAINT MARYS |
| Zip Code | 31558 |
Please comment or provide details below to improve the information on COASTAL DENTAL CARE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.